Lucy has described a scenario that begs the question of informed consent  and 
poor understanding of the relationship between pain management and  
breastfeeding. If a penile block was given to the baby then why is he crying  from 
pain? Could he be crying because he is separated from his mother,  restrained, and 
being handled roughly? It is well known and reported in the  literature that 
sucking at the breast modifies pain significantly. The baby  should have been 
placed at breast to reduce the crying and allow pressure on the  bleeding 
circ. He could also be given tylenol for pain. Shoving a bottle of D5  into the 
baby's mouth without permission of the mother is battery. The  combination of 
fasting (which I bet happened before the circ) and hard crying  drops blood 
sugar levels. Blasting with D5 is known to bounce the blood  sugar levels around. 
Did anyone check blood sugar levels sometime  after being given the D5?
 
At this point, the mother with limited English was not consulted, nurses  did 
not follow unit policy, the baby refused to breastfeed, and the mother has  
had information withheld from her. An incident report should be filed. If the  
baby is unable to complete 2 successful feeds at breast prior to discharge, 
then  community standards for discharging breastfed infants has not been met. 
Perhaps  an inservice should be scheduled with a protocol for this scenario 
created as a  result. Nurses should be required to read the published articles on 
the  relationship between pain relief and breastfeeding. A physician's order 
should  be required before any sugar or artificial nipple is given to a 
breastfed  infant. The risk management department should be informed of this and 
asked if  they could foresee a lawsuit for battery, infant health risk from not 
being  breastfed, and nurses who do not follow unit policy.
 
Marsha Walker, RN, IBCLC
Weston, MA

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